title: Endovascular treatment of wide-neck intracranial aneurysms using a microcatheter protective technique: results and outcomes in 75 aneurysms.
abstract: OBJECTIVE
  The microcatheter protective technique positions an additional microcatheter in the parent or side-branching artery to protect it during coil embolization. The purpose of this study was to describe this method and to evaluate its efficacy and safety as an alternative to a multiple-microcatheter or balloon- or stent-assisted technique for wide-neck aneurysms.
  
  
  METHODS
  A retrospective review of 74 patients (43 women; mean age, 59.6 years) with 75 wide-neck aneurysms treated with the microcatheter protective technique between January 2003 and April 2010 was performed. Immediate postembolization angiograms were evaluated by using a conventional angiographic scale, and clinical evaluation was performed by using the GOS. Clinical and imaging follow-up were available in 57 (76%) patients, with a mean of 14.7 months.
  
  
  RESULTS
  Postembolization angiograms demonstrated total occlusion in 45 of 75 (60%) aneurysms, a neck remnant in 17 (22.7%), and body filling in 13 (17.3%). The technique-related complication rate was 17.4% (13/75), and the procedural-related morbidity rate was 1.3% (1/74). All patients, except 3 complicated cases with a GOS of <4, had a GOS of 5 at the end of the study period. Of the 57 aneurysms with follow-up, recanalization developed in 5 (8.8%) aneurysms, and 3 (5.3%) cases of major recanalization were re-treated endovascularly.
  
  
  CONCLUSIONS
  The microcatheter protective technique is feasible and safe for coil embolization of wide-neck aneurysms, especially in cases that are not suitable for multiple catheter or balloon- or stent-assisted techniques.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Korea.
authors.forename: J Y
authors.initials: JY
authors.lastname: Lee
authors.forename: J H
authors.initials: JH
authors.lastname: Seo
authors.forename: Y D
authors.initials: YD
authors.lastname: Cho
authors.forename: H-S
authors.initials: HS
authors.lastname: Kang
authors.forename: M H
authors.initials: MH
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D021721:Balloon Occlusion / Q000295:instrumentation*; D001807:Blood Vessel Prosthesis; D057785:Catheters; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome